Nosocomial Infections

• What is the case scenario involving Adjoa Esther about?

  • 40-year-old woman admitted for caesarean section
  • Experienced wound complications post-surgery
  • Wound swab culture yielded Pseudomonas aeruginosa
  • Treated with IV meropenem
• What is a healthcare-associated infection (HCAI)?


  Infections acquired during the process of care, not present at admission, typically occurring 48 hours after admission.
• Who can be affected by healthcare-associated infections?

  Primarily patients, but occasionally caregivers.
• What is the prevalence of HCAIs in developed countries?

  7 to 10 out of every 100 hospitalized patients.
• What is the prevalence of HCAIs in developing countries?

  10 out of every 100 hospitalized patients.
• What is the prevalence of HCAIs in ICUs?

  42.7 episodes per 1000 patient days.
• What is the prevalence of HCAIs in Europe?

  7.5% (3.5-12.0%).
• How many patients were affected by HCAIs in the USA in 2011?

  648,000 patients.
• What is the estimated economic cost of HCAIs in Europe?

  €7 billion in direct costs.
• What is the average increase in hospital stay associated with surgical site infections (SSIs)?

  10.6 days.
• What percentage of neonatal deaths in Sub-Saharan Africa is attributed to HCAIs?

  75%.
• What are the types of infections associated with HCAIs?

  • Surgical site infections (SSIs)
  • Catheter-associated urinary tract infections
  • Bloodstream infections (CLABSI and non-CLABSI)
  • Ventilator-associated pneumonia
• What is the definition of surgical site infections (SSIs)?

  Infection of a surgical site that occurs up to 30 days after surgery without an implant, and up to 1 year with an implant.
• What is the risk factor associated with catheter-associated urinary tract infections?

  Higher incidence in developed countries.
• What is the risk factor associated with ventilator-associated pneumonia?

  Lower respiratory tract infection post artificial ventilation.
• What are the risk factors for developing HCAIs?

  • Poor infection prevention and control procedures
  • Poor hand hygiene practices
  • Inadequate use of PPE
  • Use of indwelling devices
  • Prolonged hospitalization
  • Prolonged use of antibiotics
  • Performance of invasive procedures
  • Immunocompromised state
• What are the common pathogens associated with central line-associated bloodstream infections?

  • Coagulase negative Staphylococcus
  • Staphylococcus aureus
  • Enterobacteria
  • Acinetobacter sp
  • Pseudomonas sp
• What are the common pathogens associated with urinary tract infections?

  • Enterobacteria (E. coli, Proteus sp, Enterobacter/Citrobacter sp, Klebsiella sp, Serratia sp)
  • Pseudomonas sp
• What are the common pathogens associated with ventilator-associated pneumonia?

  • Enterobacteria (E. coli, Klebsiella sp, etc.)
  • Pseudomonas sp
  • Staphylococcus aureus (including MRSA)
  • Streptococcus pneumonia
  • Haemophilus influenzae
• What are the common pathogens associated with surgical site infections?

  • Staphylococcus aureus
  • Enterobacteria (E. coli, Klebsiella sp, Proteus sp)
  • Pseudomonas sp
• What percentage of HCAIs are preventable?

  50% of all HCAIs are preventable through good infection prevention and control practices.
• What are some good infection control practices?

  • Education and practical training in infection control
  • Aseptic technique for all sterile procedures
  • Removal of indwelling devices when no longer needed
  • Isolation of patients with communicable diseases
  • Use of sterile items for invasive procedures
  • Disposal of sharps in robust containers